March 7, 2010

This will wrap it up for Thailand 2010 Medical Team International. I hope that this ejournal or blog or emails have kept you in the loop during our mission here on the Thailand-Myanmar and that you have been able to experience the roller coaster of emotions with us. These past two weeks were a blur and was filled with excitement, adventure, happiness, sadness, evictions, disappointment, hope, fulfillment, joy, camaraderie, team work, faith, and love.

The last clinic at the end of our journey was held at the Jaoporluang Uppatham 5 school in Ghan’s village near the Myanmar border. On our way up the steep mountain we saw a trail of families, primarily women and their children slowly and determined walking up the hill to the clinic still one mile away. Later, I am told that most of those people were Burmese who had gone over the mountain, crossed the border, just to come to this clinic. Most of the Akha we see live in the surrounding hills and walk down to the clinic. Ghan grew up with these villagers and we saw some familiar faces from the prior expedition and some patients were seen last time. They must have been happy campers for similar treatments or have more teeth pulled.

As they clinic begins I look around and survey what’s in store for us today. I see exhausted, weary looking people, sluggish at times but some who are actually hyperactive, some skinny while some are overweight, many look overworked, and a few that appear near death. Curiously, they are all dressed in blue. Hey, wait a minute, that’s the mission team! It’s been only 2 weeks and they’ve aged quite a bit. Get them home quick before they collapse!

These villagers are tough and strong! They define the meaning of work. They die with a hoe in their hands, men and women. I saw many 70 and 80 year olds with ripped muscles and back pain from bending or stooping over. Eighty per cent of the patients I saw today needed anti-inflammatory medications, pain killers, and steroid injections just to get back to work as soon as they can. Time is money; they can’t afford to be off of work. Their back hurts, they can’t flex their fingers, they suffer from tendinitis, carpal tunnel syndrome, tennis elbow, and joint pain. I saw an elderly lady with hunchback pushing a cart up hill. Work=food. They really impressed me with their work ethic and bring to mind the Hmong that work the fields back in Fresno in the hot sun growing the strawberries. Support your local ethnic farmers!

This was a very interesting case and a teachable moment. A relatively young muscular man, 40ish, came in with complaints of body numbness. His left hand was deformed and had severe muscle wasting from severe ulnar neuropathy. How odd that it didn’t get treated earlier. He said his feet were numb and as he took off his socks the feet were quite narrow and deformed. I thought that those feet don’t belong on that body. The toes were clubbed and he had sores, craters, and ulcers on the bottom of his feet. There was dense numbness and thickening of the feet. Usually we see that in diabetic feet so I tested his sugar level and it was normal. I got a second opinion from our chief medical director and he looks and authoritatively says, “leprosy.” Okay, as I back off from him slowly as not to reveal my panic. “Isn’t Hansen’s disease contagious?” I asked trying to avoid the “L” word. “Oh, you’ll probably won’t get it” he nonchalantly responds in his usual caring soft voice. PROBABLY. Hey, I didn’t get vaccinated for that. No one did. If I get it we’re all getting it. Besides the optometry team fit him for glasses and been exposed. Why am I the only one concerned here? Don’t body parts fall off? Luka says there’s even a leper colony in Chiang Rai. I asked if it was safe. “Oh yeah, it is safe.” But that’s what he says about everything… Luka gave the patient his card so that he can be taken to the hospital to be evaluated and tested and eventually be treated with medications. In the meantime, hopefully the antibiotics and steroid injections will offer him some palliation.

I offered to be quarantined in First Class since the rest of the team is waaay in the back (should have gotten Premium Ecomomy) to spare them the air that flows from First Class back. Bill just says I can just wear a mask. Even Pastor tried to ostracize me by pointing to a table that was reserved for me at breakfast time. If you don’t hug me when I get back I’ll understand but if you see me irritated and deformed, please don’t ask, “What’s eating him?”

This is cool. There is a Shaman, a witch doctor, that resides in the village. Traditionally, he was handed down the duties from his father but really didn’t want to do it. He was scared of demons and evil spirits and had the tools of the trade, such as, a spear or sword, a sacrificial knife, and other paraphernalia. You definitely don’t squeeze the Shaman. Well, he didn’t want to be a witch doctor any more and was afraid of burning these hand-me-downs in fear of the evil spirits; in fact, he wanted to be a Christian. The local pastor wasn’t sure he wanted to “exorcise him” so he called on Pastor Jack who, with Dr. Patton, Bill, and Luka went up to the local pastor’s home and laid hands on the patient and prayed with him. Well, guess what? Witch doctor be gone!! He prayed and he confessed his sins and accepted Christ as his personal Lord and savior. The team took the things to be discarded and burned. Later in the former Shaman, born-again Christian, came to the eye clinic with hopes of being able to read the bible. Amazing Grace.

It’s hard to use measuring sticks as to what constitutes a successful mission. The number of patients treated was a significant amount and perhaps the easiest to quantify: about 1910. Smiles on their faces of those we treated, even somewhat hidden behind the dental gauze, or the typical bow with the hands-in-prayer-position with “kup koon ka or kup koon krup” and “goo long humaday” which is “thank you” in Thai and Akha, respectively is a reflection of he success of our efforts. It’s amazing that they still thank us after we have inflicted some considerable pain or discomfort. The warm and kind human touch with our very presence that we brought from half a world away showed them that someone cares for you. And question will follow like “Who are they” or “Who was that masked man?” Christians, they’ll say. “What are Christians?” Well, have a seat, and let me tell you a story that happened over two thousand years ago…

You would be proud of the team that you sent on how organized we were and how effective every team member performed in their unique position. We all got along and strengthened our relationships with each other. Developing relationships has always been emphasized on this trip not only with our overseas friends, but also between the doctor and their patients, between Christian brothers and sisters, between husbands and wives, and between this proud father and my special daughter, Jennifer. We opened the doors to Western civilization and Christianity in some parts of the world as representatives of First Chinese Baptist Church. Thank you for the opportunity to serve God and for the support and prayers of FCBC and our friends and family. We look forward to the next trip with equal enthusiasm and it won’t be soon enough.

Hey Bill, you’ve just completed a third successful mission trip to Thailand, “What are you going to do?” “Im going to go to Disneyland!” “And run a marathon on the West Coast and run one on the East Coast just to get a “Coast to Coast” Disney medal.” I think I’m going to get you another “Goofy” medal, Bill.

Someone asked, “What will the future hold?” We will know when we get there.

Medical Team International signing off…Proud to be humble servants of God.

I haven’t seen it yet but if you pick up Fresno Magazine, March issue (www.fresnomagazine.com) you can read about some of FCBC’s missions to Thailand and Laos. A few months ago they interviewed me, a dentist, and an ophthalmologist, about our overseas mission work and wanted to write an article about it. Coincidentally, the current SALT Fresno Magazine, www.saltfresnomagazine.org, which is a Christian based magazine, has an article about the missions trips as well and has previous blogs and photos. There will be a launch party for SALT magazine at FCBC on March 25, 5:30-6:30 pm giving the mission team an opportunity to mingle and share our experiences with the congregation and the public. Refreshments and door prizes too! Please be there and support your very own mission representatives.

I think Andy and I have worms. We have been eating for two or three. He eats his usual breakfast and then the previous nights left-over dinner plates. I have eaten 12 scoops of Swensen’s ice cream in two days. Hey, they’re small scoops, okay medium scoops, not Fenton’s ginormous scoops. Swensen’s has a coup on being the only ice creamery chain in Thailand. Good thing Baskin Robbins isn’t here otherwise I would have tried all 31 flavors. When I have been on Atkin’s diet for three months, I go into carb withdrawl. I am just hoping the worms kick in so that I can loose some of this weight. I feel like this has been a cruise ship meal plan. Once I get down to my desired weight then I’ll take the worm pills. Wherever we go, the hosting village, church, or school like to feed us. There is no shortage of food. Kind of Chinesey. They want to make sure that we get food so they never run out and as gracious guests we like to show them that we try everything and leave some food on our plates so that they know that they didn’t run out. The team has experienced a little GI upset but no Montezuma’s revenge so far. The common question is, “Is it safe?”

We should be asking the same question ahead of time before we drive on some of these roads. Today was actually fun. It was another one and a half hour drive with the last half in the hills through dirt roads and potholes. We went up and down and we were excited to find out if we were going to survive this drive. We drove in vans and every now and then the van would bottom out and we would go “Oh!” and then take a big dip and go “Ah!” Pastor likes to go “Woo hoo!” The poor van. I don’t speak Thai but I think the driver was mumbling, “I’m not getting paid enough for this.” It was a nice scenic route along the river with tiered harvested rice fields, and cornfields, grazing water buffalo, and huts and home lining the roads along the way. It’s almost envious because back home when we want to get away and “rough it” these are the places that we like to go: to a cabin in the woods or camping, and they get to live this every day.

I can’t believe that a school is located way out here. If I had to travel this far for classes I would prefer to be home-schooled. Apparently the principal, who went to college with Luka, drives here each day from Chiang Rai city. We approach the Pahwang School for the local Lahu villagers. Several hundreds of children attend this school from elementary to high school and some reside in the dormitories. It is a relatively nice complex with a playground and a basketball court. You wouldn’t think a building such as this would be located, or built for that matter, in the boonies. Just thinking how the construction equipment could make it out here is mindboggling.

A group of children were waiting on the playground and I was trying to get them to wave at me while I was videotaping them but only a few responded to this attempt of an icebreaker. Then I recruited Kane, Jen, and Ghan to do “The Wave.” You know, go up and down while the next one to you goes up and down and so forth. Only half of the group even attempted this exercise in calisthenics. They probably thought we just looked silly. I am glad that we were entertaining.

It’s a challenge to influence a primarily Buddhist nation but perhaps it can be done one village at a time. Ghan told me that Auntika’s sister lives out here and worked with South Korean Christian missionaries who have visited before. In the past, the children used to get together in the morning and praise the monks and do Buddhist worship. Now, most of the children are Christian so now they get together in the morning and pray the way Jesus taught us to pray. Praise the Lord!

We quickly set up clinics and encountered the usual pediatric ailments: runny nose, stomachache, hormones, headaches, lice, fevers from holding the thermometer close to the light bulb, reading and visual issues, and dental caries and tartar build up. I got to take a eyebrow cyst out and sew up a chin laceration. It was impressive that after lunchtime how the children gathered and squatted in a circle in the yard and many of the kids brushed their teeth in unison. At the end of the day I had and opportunity to print some photos. At first, no one wanted his or her picture taken. Then I printed one up for a partially blind girl. The kids started to gather around the printer as the photo developed and THEN they wanted their picture taken. First one, and then another with a friend, then a group and then a family and then a class, etc. We communicated in sign language. The kids would just point to who they wanted in the photo and then give me the number of photos they wanted by holding their fingers up. They are little hams. We ran out of time to print pictures for everyone because by then a small crowd had formed and I couldn’t do everyone but for those who got a photo, this may be their only childhood Kodak moment. A bit of advice for those, including myself, who take oodles of digital photos: print some of them now or periodically so that you have a hard copy or you may not find them years later and you will be empty handed.

The school was grateful for us coming and gave out hand-made bracelets to the members of the team. We said our good-byes and now the children were waving as we drove off in the vans. It was a hot and humid day but well worth the trip. It takes a lot of energy out of the team so most sleep on the way back. For some the ride back doesn’t bother them and they take naps and just look like bobble-heads. It’s pretty quiet though and gives us time to reflect what we did today and for the past two weeks and how the experience has touched each of us.

We have one more clinic to do at Ghan’s village located about one hour away. We went there before and treated a lot of manual laborers and expect the same. I don’t know how many people we have treated and it really doesn’t matter because we treat each patient one-by-one, one at a time. Whether it’s a pill, a filling, a pair of glasses, or a stitch, we have showed others that someone cares for you and that is reassuring and a feel-good moment. For Christians, God cares for us, and that is not just for a moment, but, for eternity. It is this enduring love and security that we want to pass on to others.

I had a terrible night. Jen wanted to look at my CF card from my digital camera to review the day’s photos for posting on her blog. She hooked it up to her computer and said that there were no photos. A cold sweat appeared as I peered over my eyeglasses with a raised eyebrow. Jen defensively says, “I didn’t do it.” I put the memory card into my camera and it read “no image.” Okay, so I put it the memory card in the computer and looked onto the card, which previously had 465 photos on it and it did not show any folder or photos, as if it were blank and unused. After my explicative loosely translated as “Oh doo doo!” I was hoping to find a recovery program somewhere on my computer but to no avail. Light bulb went off: Internet access. Long story short (I actually can if I try), if it happens to you, take the memory card out of the camera and don’t take any more photos and go to www.lexar.com and get Image Rescue IR4, which recovered 99.5% of the photos intact that were “hidden” on the card. It’s worth it even at 3:30 am.

I want to introduce Libby Andersen, RN, FNP, is a nurse practitioner from Seattle who is a very cordial and friendly individual. She was introduced to Luka and his foundation in 2005 when she came with her church, Seattle Grace Presbyterian Church, who helped build a church in Thailand. She wanted to come back to Thailand to help in a medical position so she prepared herself for this by first workeing for a family practice group for three years to get familiar with primary care medicine. In November 2008 she began volunteering at the Akha Youth Development Center helping with mobile clinics to serve 12 Akha churches, public health education, and nurse at the AYDC medical clinic. Libby has been extremely useful and is an asset to the team because of her medical background helpful with triage in addition to being a translator for both Akha and Thai speaking patients. She has accompanied the team to most clinics and will stay here in Thailand for several months more after we leave and will be able to follow up on some of our patients that we have treated. Thanks Libby for all that you do for the foundation and for the sacrifices that you have made and the hardships that you have endured.

Our itinerary, as you now know is not written in stone. The village that we were going to go to is located way in the hills and it was determined that the vans couldn’t go up the bumpy roads so we would have had to change to 4 x 4’s. It was felt that the drive might be too rough for the medical team. What are we, a group of pansies? Instead we were detoured to the Song Serm Sart (“promote religions”) Presbyterian Church, located about an hour away in the pineapple village, whose members are primarily Thai citizens. That means that most of them have access to health care and many are already on medications but want refills or a second opinion. We had a nice spread with plenty of room for the entire team and lots of elbowroom. I got excited when they rolled in an actual hospital bed for either surgery or examinations. They were just being hospitable. We prayed together in the beginning as a group. Today, I tried to be more cordial, less stuffy arrogant impersonal surgeon-like, than I have been, with less business-like and production line mentality since Bill put away the whip. The patients still, however, couldn’t tell I was smiling since I had too much BOTOX on-board.

The medical team saw its usual ache and pains and GI complaints. Two patients stood out amongst the crowd. One young man was burnt with acid when he was 5 years old protecting his brother from getting spilled on. One half of his face including the eye and ear were destroyed with subsequent scaring on his face from the burns or from skin grafts. His hands and arms and legs and back were not spared either and he had contracted scars and keloid scars all over his body. The best we could offer was to get him glasses to read and for distance because he was afraid of loosing his job as an air-conditioning tech. Dr. Tajiri and Dr. Chinn had to do some fancy fitting in order for the glasses to fit on his face since his nose was shallow and he only had one ear. They were able to fit him for both reading glasses and one for distance.

Another child, seven years old, but with severely stunted growth and blindness had a severe congenital defect. The young mother was told during an ultrasound that the fetus didn’t look right so the mother took some pills to abort the fetus. Then the grandmother said don’t abort the baby because she’ll take care of the it if there’s a problem. Little did she know the severity; the baby went to term and was severely disfigured, blind, and stunted in size. But she cuddled the child with pride and a great big smile. Apparently, Luka has seen this a couple of times before where the picture is the same. The young mother takes a pill to abort and the baby goes to term and with similar looking birth defects. We took pictures and gave it to the grandmother who was very grateful to have a picture with her grandson. The child had cataracts and nothing could be done. I often feel helpless or useless despite having sophisticated American medical training to leave the families or patients disappointed especially when they have traveled so far with a lot of hope.

Perhaps Kane was more helpful in his contacts with a few patients with whom he prayed. He put on his spiritual counselor and psychiatrist hat and he said that they had “similar problems, only different language” regarding dealing with stressful family issues between in-laws and relationships with the immediate family. With one patient who came in for a refill for anti-depressants, he didn’t think that medications were the answer to her problems; neither did she. He was able to get a bible and read some verses to share the gospel to the patient, who was torn between Buddhism on one side of the family and Christianity on the other side, to use scripture to deal with common problems. The patient asked him to pray with her so Ming, Luka, Kane and the patient prayed. He must of spent about an hour with her working through lunchtime but I think Kane felt that he was fed, more importantly, spiritually.

We felt a strong relationship with this church because they are our Christian brothers and sisters. The church is the family. They expressed to us that the church was praying for healing and that God answered their prayers by having this medical team respond to their prayers. In other words they felt that, “God sent you.” So it is an amazing feeling that Medical Team International was the answer to someone else’s prayer. In appreciation, they gave each member a souvenir bag of dolls, pins, and key chains as a token to remember them by. Those tokens along with the memories and photos make it impossible for us to forget our experiences with them.

There’s been a rash of well, rashes. I noticed a peculiar rash on Jen’s neck. Odd place so I put antifungal on it. “I want a 2nd opinion”, she says. “Heat rash I imagine” Dr. Patton and suggests a steroid cream. Then he noticed it on my neck. Odder still. Gail had a rash as well as Bill. Come to think of it, Jack had a rash on his chest. Epidemiologically analysis suggests…Akha bead necklace that several of us were given as a “Thank you” by the Akha women villagers when we visited the Huisan Akha village and the church last Sunday! Working diagnosis: allergic contact dermatitis. We were beadazzled.

Medical Team International is down the home stretch. Today’s period of rest and relaxation was fulfilled by a trip to the Princess Mother’s Mae Fah Luang garden. She was the mother of the King of Thailand. The beautiful garden is hard to describe unless you were there and had the usual and unusual plants and vegetation. This was located way up the mountain about an hour away in the Mae Fah Luang district from Chiang Rai city. There is also The Doi Tung Royal Villa where the royal family spends time away from the palace. It’s like a large rustic cabin situated in the forest. You can visit www.doitung.org for more information. The Princess Mother established the Doi Tung development project to provide land for farmers to grow crops instead of opium. We visited a factory where we saw how some paper is made from the pulp of mulberry, pottery factory, coffee plantation, and clothing factory. It is amazing to see how the threads are woven together and then weaved on looms to get different patterns to generate colorful material…all by hand. These workers work hard in monotonous jobs sitting on floors or on desks or in this looms. Not an enviable position but pays the bills I suppose. This type of blue collar job is not for me. This gave us the opportunity to by better quality products such as scarf’s, purses, clothing, pottery, and coffee to help support the local economy and satiate our appetite for shopping.

Tomorrow we will be going to a Lahu village, another hill tribe group. So far we have treated several different ethnic members of the hill tribes including Akha, Hmong, Khmu, and Mien as well as some Thai citizens. The following day we will be going to a school of several hundred children. We went there about 4 years ago. We wanted to go back to the prison but were unable to be granted permission. The closest we got to being in a prison was in Myanmar and instead of blue uniforms, we would have had orange ones. So far we have treated 1225 patients keeping in mind the setback in Myanmar where we lost a day and a half. In the beginning of the trip I was hoping for a goal of “2010 in 2010” and it might be possible. I have to remind myself that quality of care and providing quality of living for these people takes treating them one by one and that its not the quantity of people treated. Already this trip has made a tremendous impact physically and spiritually. The Chinese have a saying when things are very good they say its “Best Quality”. That’s our goal: to provide the best quality care that we can in the conditions that we face.

These mission trips allow us to build relationships with others. Pastor pointed out that many ethnic groups that we encounter don’t look you in the eye, but an old man, after he got his glasses, came up to Pastor and looked into his eyes and said, “I see you.” I guess he’s saying I’m connecting with you.

Our devotion makes us realize that when we go on this missions it’s by God’s hands and not our own. The Akha and the Khmu have visions that border on what some may think are of delusions of grandeur. But they are not delusions; it is a testament of their faith. They don’t hope that “if it will happen”, but plan on “when it will happen.” They are teaching US a lesson in faith.

Medical Team International (giving you a break in blogging)…signing off.

Our condolences to the Quong and Kam Don family for his recent passing this past weekend. God called him at 94 years-old. He was a gentleman who reminded me of my father-in-law. We will miss him dearly and we pray for Kam’s health and her sadness as she mourns Mr. Don’s passing.

Bill is trying to boost the morale of the team so we were treated to an upgrade in hotel accommodations. We stayed at the Nan Khong Riverside Hotel (www.namkhongriverside.net) on the Chiang Khong strip. The city is a hot tourist attraction since it has access to destination spots in Thailand and access to Laos just across the river. We had a nice dinner overlooking the Mekong River with Laos in the background and watched the moon rise over the hills reflecting on the river. Although we have been used to Southeast Asian music the local band’s renditions of 1970’s American music was both nostalgic and heartwarming.

Several members awaken early to walk along the river. A breakfast buffet was an opportunity to bond with members of the team. It is one of the benefits of having team members already familiar with other whether they are friends already or relatives. Relationships seem to get stronger. If tensions form, we just get to change roommates. So far no requests yet. When I talk to Lena, my most faithful reader, she is excited to hear how we are doing. She always asks, “How are you and Jen doing?” She’s worried that we might, say, disagree on different perspectives. Well, Jen and I have known each other for over 24 years. I am going over the Ten Commandments with her emphasizing, “Honor thy father and your mother.” I had been looking forward to spending some time with her alone for father-daughter bonding.

Many of Lena and my friends have similar aged children and as they grow up they move out and go their ways. We only hope that we have given them a perpeptual home base so that they may have a home that they feel secure in. We welcome and cherish the times when the children actually want to come home and spend time with their families. Some children never return. We continue to leave our children’s bedrooms alone (short of being a shrine) so that when they do come home, albeit briefly, it brings back fond memories of their childhood. It gives that sense of family. Even when Steven comes home it’s literally music to our ears when he plays the piano. What a treat. Lena loves it when they come home and even tolerates the messes that they make; it makes the kids feel at home too. You know then that she really loves to have them home. Allison will be leaving soon and I hope that I will still have time to bond with her before she goes off to college, get married, have four children, and get a steady job. Don’t let those chances escape. So, to all the empty nesters I can and will relate. So I cherish this moment that I have to spend with my favorite oldest daughter, Jennifer, not be confused with my favorite youngest daughter, Allison, or my favorite son, Steven, as they are known. I’m not getting any younger (although I can look younger since I have friends in the business). Jennifer and I get to witness in our different ways and you can see our different perspectives and impacts that this trip has been on us on our blogs.

It was nice to just walk back into the room where we worked last night, which was already set up and just start working. No setting up chairs or tables. No unloading trucks and unloading bins. No looking for power outlets. No jockeying for position. Bill swung open the doors and just said, “Bring It!” We worked our tails off today. Lots of patients showed up, several hundred. Lynelle’s area was a haze due to the cloud of dust of tartar in the air from grinding it off the teeth. The floor was littered with teeth from extractions and Bill was melting his gold jewelry for bling and gold crowns. The medical docs were injecting left and right (I guess that means bilateral) letting the patients know that we mean business. They got the point. The eye people see the light at the end of the tunnel and it’s not tunnel vision. Leroy and Jen have dueling grinders to see who can grind out the most lenses. Dr. Chinn gives sight for sore eyes while Dr. Tajiri holds up the finished eyeglasses in the air and triumphantly declares, “And let there be Sight!”

I’ll have to say that many, not all mind you, we Americans are spoiled in our cushy jobs with 15-minute breaks in the morning and 15 in the afternoon including an hour lunch break. We get overtime pay and weekends off. We are subject to injuries too, but we can claim a worker’s comp. injury and get sick leave and even get retrained at WC expense, even if it was our fault for getting injured in the first place. Then there are vacation days, holidays, sick leave, and retirement. We can hang around the time clock discussing what a tough day it was waiting for 5:00 pm to click around. If anyone was offended we should be guilty or appreciate it to have a good paying job. Until you see what these people do just to survive and make a meager living, you I don’t think one can truly understand the meaning of hard labor. I still can’t relate because I am not doing the hard labor but I see it’s effects first hand. I think that is why they call it WORK! I feel lucky or guilty or both that people pay me for unnecessary surgery; surgery they WANT and don’t necessarily NEED. Yes, I admit that I am one to have a cushy job but I am truly humbled by what I see that some of my guilt is eased and I attempt to fulfill my obligation to help my fellow man-kind. My plea to you is to take your God-given talents and get out of your comfort zone and give back. Not only is it the right thing to do it will make you a better person.

They average patient that I have seen in the clinics have been less than 5% body fat, rippling muscles that are tense and tone and developed no matter if they are a teenager or a 75 year-old laborer. They’re buff. I’m envious. The children work or beg. The mothers and fathers work. Grandma and granddad work. It could be bailing bamboo, gathering sticks, weaving yarn, getting water, feeding the animals, harvesting vegetables, planting rice, slaughtering the animals, or caring for children; they redefine the meaning of labor and work 24/7. I really admire these people in the 3rd world working just to put food on the table. They show up at these clinics with so many musculoskeletal complaints and repetitive strain injuries. They want to be cured just so that they can return to work. They have a great work ethic and with our limited resources we do what we can and they sincerely appreciate it. Pastor Khoon summed it up as we gathered our things and are about to leave this village by saying that it was through God’s grace that we came to this village and that He made it possible because we are all children of God. Thank you for the opportunity to serve you.

Health check. There have been a few illnesses and causualties.

After all those nine vaccinations, Jennifer, of all people has been inflicted with the common cold. I am proud of you for hanging in there, baby girl.

David has come down with a nasty cough which is getting better but now we are out of dextromethorphan. He gets dibbs on the meds.

Richard’s plastic chair leg collapsed under him due to, well, er, a, too much, a, how do you say, a,… Let’s just say that they don’t make plastic chairs like they used to but fortunately he landed on something soft. He was doing a different type of spread eagle.

Richard hit his head on the doorframe sustaining a small laceration on his head. Good thing it hit something hard. The average Southeast Asian that we see here is less than 5’ and weighs less than 90 lb.

Richard fell into the bushes sustaining a green stain on his pants. To his defense he was looking for trash bin for Jennifer’s tissue that she brought out of the outhouse since there is no place to flush it. (Jennifer is the only one who wears a mask into and out of the outhouse. Is it you, Jen, or is it them?)

Poor Richard, I thought I was clumsy. You were in the Marines? What does it mean Special Forces? Like Special Olympics?

I tripped over the edge of the raised floor and did a kung fu roll to purposely land on my back to absorb the fall. I am good at this because in kung fu I’m always the one getting knocked down. Interestingly no one offered me assistance or CPR. I get first dibbs on the AED since I brought it.

Lynelle’s chair collapsed under her due to, well, er, a, see #3. She’s very graceful when she lands.

Kane almost chopped off his finger from a ceiling fan.

10. Bill’s is suffering from insomnia from all the details that he has to deal with so he reads my blogs in order to fall asleep. Thanks Bill. You made me do them.

MTI traveled about 2 hours to the Khmu Eane Village in Chiang Khong on the border of Thailand and Laos divided by the Mekong River. The mayor is known as King Khong. We will be working here for the next two days. To get here the roads are bumpy and winding and I’m glad that Jack has a steady supply of carsickness meds. We have covered a lot of territory going into Myanmar and across Thailand with long hours on the road. Thus, the exposure as a passenger subjects us to risks and can be hazardous to our health. But if you have the opportunity to ride scooters like Pastor Jack, Andy and Dr. Tajiri in Thailand or will be visiting these parts, I have made several observations and recommendations about traveling on the road that might be useful.

Wear a seatbelt even though the driver wraps them up neatly with a rubber band and doesn’t want you to use them. Markings on the roads and traffic signs are for suggestion only. A few drivers follow the guidelines and even though there are no posted speed limits most vehicles don’t have enough horsepower to drive very fast although some try. It is suggested to stay on your side of the road (which is opposite to the US, unless you are back in Myanmar and the only direction I want to drive is to the border). The drivers like to meander around the curves and utilize the principle of “the shortest distance between two points is a straight line” so as long as no one is coming on the other side they have another lane to use. Although some vehicles have GPS systems and maps they still can get lost so they generally leave them off. You are really a skilled driver if you can watch a DVD and drive at the same time.

Drivers of scooters have a death wishes. As a courtesy, two honks alert the scooters who are in the way of a larger vehicle while three honks, whaling on the last one means the driver really means it and you are about to be road kill. And if you are on a scooter and get hit it was your fault for being there in the first place. If you get in an accident, the larger vehicle wins. Scooters are a one-size-fits-all. If you have 1,2,3,4, or 5 members of the family plus a pet and fit on the scooter and the scooter moves, you have transportation. Remember, it’s not that impressive since 2-3 of them make up one average American. Pets may travel in a basket, on the seat in front of the driver, or if you are a monkey you can sit behind the driver if you know how to hold on with two hands around the driver’s waist. The scooters, who are like ants, yield to the larger vehicles. Scooters are multi-functional and you may stack things as high as you want as long as you adhere the physics principle of center of gravity. The centrifugal force allows you to drive in a straight line. You can use an umbrella as a windshield. You don’t have to have a license to drive a scooter and there doesn’t seem to be an age limit. Scooters can drive on either side of the roads in any direction. A recent helmet law reinforces the emphasis of driver safety involving scooters. Women passengers like to ride sidesaddle because straddling the seat with a dress is not lady like; they have uncanny balance even when reading a book. Children often sit in the front, unless they want to stand, in order to block the flying debris and bugs from hitting the driver, which might cause an accident. Interestingly there doesn’t seem to be road rage. I think because there are no traffic rules no one gets disrespected, no one has expectations, so no one breaks the rules, so no one gets angry, therefore, no road age. Americans should learn from this simple lesson. Remember to share the road. Driving is a privilege, not right. Happy and safe driving!

Now that we made it safely here at our intended destination, safe and sound, our local contact for Eane village is Pastor Khoon and Pastor Phonekeo. Pastor Phonekeo is from Fresno and is associated with the Laotian congregation at the Mennonite Brethren Church in Fresno. Born in Laos, of Khmu heritage, he felt that God led him to this village and seven years ago he started this church. In the first year of the churches existence there were three Christians and today there are over 100. He will leave the church in Fresno and become a full time missionary back in this area next year.

We arrived at the one room church and set up shop. They had to retrofit the sanctuary that we are working in with more power lines since the dental and optical teams are power hungry. They were shocked at the lack of outlets. These teams have a constant power struggle because some feel empowered with all the energy that they can get. Some of them are AC/DC. Watts the problem here. You need a high voltage guy like Bill to take control and keep us grounded. All the equipment seems to work so the team gets charged. Currently, it’s electrifying to see how we all work together.

The initial group of patients we treated traveled from communist Laos up and over the mountain and illegally crossed the Mekong River just to come to the clinics. We have to see them first so that they can return to Laos before sunset. They seem to have more illness than some of the other groups we’ve treated with multiple conditions requiring more medications, some, which we do not even have. They have traveled so far with vague complaints of total body numbness or pain or achiness “all over” and it’s hard to pinpoint a cause for their complaints. Furthermore the language barrier compounds the translation of their symptoms. Without lab tests or X-rays we really have to use our diagnostic skills and treat our best guesstimate. I just say, “When in doubt, cut it out.” A lot of them are dehydrated and Andy is antsy to start an I.V. to rehydrate a patient. I suggested giving him bottled water but there were several gasps amongst the team. Apparently there is a water shortage and they want to conserve our supply. Okay, go ahead and spend $50 on that I.V. ;that sure makes sense That’s why there is a health care crisis in the US. Then add all the unnecessary surgery that is done…wait that’s all I do, but my patients want it. I’ll get off my soapbox now.

I think that Lynelle is carrying the team. In fact, I know she is. She spent at least 45 minutes alone on this one patient with a 50-year build up of tartar. Exhausted, she felt triumphant and yelled, “Victory!” and raised her hands. It’s not unusual to have the dentists gathering around talking about the stock market or golf swings while Lynelle is working in the background. Is that why you invited her, Bill? And Bill has way too much time on his hands. He comes around the medical turf and tries to triage the patients and wants us to pick up the pace. We’re just doing fine, thank you very much. Why it was just yesterday during one of Pastor’s dinner lessons that we talked about teamwork and he was teaching us “Each of you should look not only to your own interests but also to the interest of others. (Phil 2:1-4). Is that what your doing? Pastor Jack prepared a lesson book for each night with scripture and responsive readings. At dinnertime it is a nice way to reflect on the days experience to see how both the group we treated and how the team was touched. It also gives us encouragement for the next day because we feel that we are doing what God wants us to do: serve his children and spread the Gospel by example.

MTI saw about 200 patients today and we are expecting 200-300 from three villages tomorrow. It’s a testament to their trust in foreign doctors and to those who refer them to the clinic. Many of them are in dire need of care and endure hardships including illegal crossings of the border that we don’t want to disappoint them by either not providing health care or not being able to improve their health status. Many of the medicines only last a month and we hope by identifying a disease we can educate them to help themselves. For example a patient who had GI pain and chronic cough was advised to stop smoking, stop her daily whiskey consumption, and avoid spicy and fatty foods. A newly diagnosed diabetic can be taught about hydration and limiting sugar intake to slow the progression of the disease in addition to some of the limited medications. There are a lot of repetitive strain injuries that can be helped with proper ergonomics. Of course the optometry dept. continue to improve vision and ability to read and provide an instant cure for most patients. Even in the US we have to wait 2-3 weeks for glasses. The dental dept. also provides eventual relief by tooth extraction or restoration.

At some point the questions will be raised as to “Who are these people that make sacrifices for us?” that will give us the opportunity to spread the gospel. Despite our trials and tribulations and the hardships and setbacks that the team experience during this trip, I believe that there is no bad news, only Good News.

Medical Team International half was through…more to come, stay tuned for part 2.

QUOTE OF THE DAY: After our chaotic and hasty departure from Myanmar Jack Patton said, “I usually only drink at home.”

We look forward to this day as we are going the Huisan Akha Village to see some familiar faces. This is Luka’s church and we are going to attend church service. On the 7th day God rested and since we are not God and don’t work as hard as Him we get to work a half a day. The time of season is hot and humid and my most memorable moment is when we went during monsoon season and the river current was quite fast and strong and our vehicles could have been swept our off the waterfall. Now I was sincere and I warned Leroy about the risk and he rolled his eyes because he can’t trust me now. I wanted him to be ready to capture it on video. Okay, so it wasn’t as torrential as I thought and one of the 4 x 4s was spinning donuts in the shallow stream and later people were washing their motor scooters and cars and some children were playing naked in the stream. So it wasn’t exactly life threatening as I thought and anyway, we had enough excitement for this week.

We drive up the dirt road through the village and the villagers are waving at us as if they have been expecting us. As we ascend up the steep hill towards the church we are greeted by an elderly couple who shake our hands as we pass by. That was interesting since they usually greet us with both hands together in a praying position, fingers pointing up and bowing saying “Sawasdee.” Perhaps they’ve adopted the American tradition or wanted us to feel with our own American gestures. Some greeting us with a necklace of beads as a token of their thanks for coming. Dr. Tajiri hitched a ride up the hill on the back a motor scooter driven by Luka hanging on for dear life; I think he wanted to drive. Yesterday Pastor Jack played Easy Rider and took a scooter for a spin around the foundation’s compound and said he felt that he wanted to keep on going down the highway. Bruce, who has ridden for forty years was very tempted to hop on a Harley here but says Nannette won’t let him ride one. What happens in Thailand, stays in Thailand.

Many of the villagers are in their best Sunday dress with traditional Akha headdress and clothes. It’s so cute to see a child in the outfits as well. Immediately we start recognizing patients and relatives of Luka and his family of helpers. My betel nut buddy from the past smiles proudly displaying her dark red blackened teeth at me and we immediately connect since that was the least memorable moment for me-when she gave me her dose to try and I passed out for an hour; that what the team tells me. As a welcoming gesture, she reached into her purse to pull me out another one but really, it was too early in the morning and I had to work; I usually like to have betel nut with my dinner. Luka’s mother is dressed more contemporary and she has this stylish Star Wars T-shirt on with her Akha headdress. May the Force by with you. We meet Luka’s father as well and he appears to be standing proud saying “That’s my son.”

We attended the worship service and we sang hymns in Akha. Pastor gave a mini-sermon and several members were either praying a very long time or nodded off. Similar to when Pastor Jack gives his sermon back home. Pastor thanked the church for giving us the opportunity to come and serve them again and how God sent us here and that we are brothers and sisters in Christ and gave a talk about uhhh, ummm; I can’t remember I fell asleep. I’ll have to see Leroy’s video. Thank God we didn’t have to sing; we were spared the humiliation. We will save our talents for the karaoke bar and after betel nut!

The villagers brought some of their offerings as food and brought vegetables and fruit and placed them on the altar while some poured bags of rice into a large community container. It was their way of giving back. The goods were auctioned off at the end to raise money for the church, kind of like our doong fundraiser. The team members took up a collection and Pastor presented a group offering to the Akha pastor. When he collected the offering from us he went around and asked ”Do you want to give again?” He liked the idea so much that I think he wants us to pass the offering plates around again back home. Be prepared. Now, now for most of the congregation it will still be less than 10%.

One of the deacons stood up and talked directed at the team and loosely translated (my Akha isn’t very good) he felt that God put the village on a hill so that we could find them. He kept some of the elders alive so that they would have the opportunity to see us again. All of us together, Akha and us Americans, are all brothers and sisters in Christ. Thanks for coming back, we knew you would because you said you would.

We worked half a day but it seemed longer. It was getting late and triage had to deal with turning about a dozen patients away. It’s not a good feeling. Andy felt that we didn’t complete our job and felt bad for the patients, especially after traveling miles. Logistically or for the sake of the team members’ physical state there has to be limits on what we can do or how many we can see.

Another frustrating moment was for Dr. Chinn. The process of getting glasses is very long and arduous. The patient has to do an eye exam by first reading the chart. Then Dr. Chinn examines the eye itself for disease and determines the needed refraction. Then Dr. Tajiri determines which lens is needed for that prescription and Jennifer and Leroy grind the appropriate lens, smooth the edges to fit snuggly into the frame. These are handcrafted. Then the glasses need t be fit on the face adjusting the arms and nose pads. So after going through all that, he asked a patient if he can now see the clock which was an object in the distance. “No”, the patient replied. Surprised, Dennis checked him again, looked at the eyes, reconfirmed the prescription, put the glasses back one him and asked once again if he could see the clock. Again he said, “No.” Now we don’t’ see Dr. Chinn really frustrated and you can see him saying, “In all my 57 years of practice…” He readjusts them again, checks the Rx and was about to make brand new glasses and he basically blames the patient our of frustration, “I don’t understand why you can’t possibly see the clock??” Dennis is not chuckling anymore. He’s about to say “Are you blind, man?!” The patient turns to the interpreter and points toward this huge object. As Pastor describes it, “He couldn’t see because my fat head was blocking his view.” After Pastor moved, the patient had 20/20 vision and could see the clock.

Working the production line and experiencing bottle necks is taking its toll. Poor Jennifer, on her very first trip, got so exhausted she passed out in her chair, snoring. We checked to see if she was arousable. “Hey, it gets so slow waiting it’s time for a nap.” Jennifer there are no such things as breaks; there are no child labor laws here in Thailand. She’s not use to manual labor. I bet she was raised with a silver spoon, almost positive. No, I’m sure of it.

Jack, holding his chin up high, was so proud to say that a patient (my betel nut buddy whom he’s trying to steal) felt that Dr. Patton cured her aching shoulder because after the injection she had total range of motion and she could do jumping jacks, handstands, and cartwheels once again. “It’s a miracle! I’ve been cured!” she exclaimed, dropping to her knees, kao towing, and kissing his feet. I think that Jack was trying to get on her good side for some betel nut as a token of her appreciation. And then Jack had the audacity to say, “Mark got a chance to do good work.” A chance? CHANCE?? You mean I haven’t done any “good work” yet. Thanks a lot. I’ll have you know that I cured two people today. Okay, so it was just a mole. But it was hairy and big sticking out on her chin. People would say, “Is that a spider on your chin?” After I cut it out she proudly wanted to take it home so I gift-wrapped it for her. Yes it was that women that Pastor came into the room and suspiciously said, “Why are you in bed with that woman, doctor?”

You try working in those conditions, doing surgery in a dark room with only a flashlight, operating literally on my knees and sitting, I said sitting, on the bed, which was the only makeshift operating table available, contorting my body in between back spasm, trying to sew up flesh with throw away instruments. I’ll have you know that Luka’s dad came to me, to me, Jack. I removed a 1 lb. fatty tumor, okay maybe 1 oz. lipoma and a neurofibroma from his back. I got HIS back; I wish you watched mine, Jack. Just wait for that local anesthesia to wear off then let’s see how cured she really is. Who’s the hero now?

I’m sorry; I got a little testy. I know, it’s not about me. It’s about them. Jack, let’s go have that drink, my treat.